Orthodontic treatment methods, systems and apparatus for use therewith

ABSTRACT

Systems, methods, and apparatus for creating a mold of a patient&#39;s teeth to which are installed orthodontic appliances with a support assembly bonded to a tooth. The appliances may include a corresponding corrective assembly with a wire engaging portion removably coupled to the support assembly. The systems and methods may include removing a corrective assembly from a support assembly, applying unset molding compound to the patient&#39;s teeth and corresponding support assemblies, setting the molding compound into a mold, and nondeformably removing the mold from the patient&#39;s mouth. The support assemblies may include a marker portion to indicate the position of the wire engaging portion of a corrective assembly that may be removed prior to making a mold and/or installed after making the mold. Marker assemblies adapted to removably engage a support assembly, and including such a marker portion, may be temporarily coupled to support assemblies prior to making a mold.

RELATED APPLICATIONS

The present application is a continuation patent application that claimspriority under 35 U.S.C. §120 to U.S. patent application Ser. No.11/708,769, which is entitled “Orthodontic Treatment Methods, Systemsand Apparatus for Use Therewith,” which was filed on Feb. 20, 2007, andwhich issued on Aug. 10, 2010 as U.S. Pat. No. 7,771,640. U.S. patentapplication Ser. No. 11/708,769 claims priority to similarly entitledU.S. Provisional Patent Application Ser. No. 60/774,701, which was filedon Feb. 17, 2006. The complete disclosures of the above-identifiedpatent applications are hereby incorporated by reference for allpurposes.

TECHNICAL FIELD

The present disclosure is related generally to the field of orthodontia,and more particularly to methods and apparatus for orthodontictreatment.

BACKGROUND OF THE DISCLOSURE

During orthodontic treatment, it is often desirable, and in some casesnecessary, to create molds or other impressions of an orthodonticpatient's teeth. When conventional orthodontic brackets are not mountedon the patient's teeth, a variety of suitable molding compounds andimpression methods may be used. However, when conventional orthodonticbrackets are installed on the patient's teeth, the range of suitablemolding compounds and impression methods is much more limited,especially when it is desirable or necessary to accurately reproduce theposition of the archwire-receiving slot, which is defined by theorthodontic brackets, relative to the patent's teeth.

Many conventional molding compounds, or materials, that are suitable forcreating molds or impressions of a patient's teeth prior to theinstallation of orthodontic brackets are unsuitable for creatingimpressions of the patient's teeth while the brackets are installed.While these compounds, an example of which is polyvinylsiloxane, aresuitable for creating very accurate molds of the patient's teeth,including impressions that are suitable for destructive scanning, orimaging, processes, the molding compounds set, or cure, so solidly thatthey are likely to debond (detach or otherwise remove) orthodonticbrackets from the patient's teeth, damage the orthodontic brackets,and/or deform or otherwise damage or distort the mold during the removalprocess from the patient's teeth (and installed orthodontic brackets).Specifically, the bracket is typically connected to a patient's toothwith an adhesive that is not strong enough to withstand the impartedforces as the set molding material, or mold, which also extends aroundthe brackets, is drawn away from the patient's teeth. As a result, thisremoval of the mold may debond the bracket from the tooth as the mold isremoved from the patient's teeth. Such a rigid impression material isalso prone to solidifying around the undercuts, wings, or otherprojecting portions of an orthodontic bracket and thereby preventnondeformable removal of the mold without damaging the bracket or themold.

Other molding compounds are suitable for making impressions of thepatient's teeth even after the installation of orthodontic brackets, butthese molding compounds are formed from materials that are sufficientlyflexible, soft, and/or deformable that they are not suitable to createmolds for use in some orthodontic applications, such as applicationswhere very accurate, or detailed, representations of the patient's teethand attached brackets are needed. One example of such a compound isalginate, a natural polymer. Such materials, once set, are likely totear, deform, or otherwise distort during removal of the set moldingcompound, thereby rendering the resulting mold unable to accuratelyreproduce the position of the brackets and/or archwires relative to thepatient's teeth.

A further method of creating very accurate representations of apatient's teeth after orthodontic brackets are installed involves theuse of CT scanners or other intra-oral scanners that create images ofthe patient's teeth, including any attached orthodontic brackets. Theseimages may be used to make electronic or other models or representationsof the patient's teeth and the attached orthodontic brackets. However,this scanning process requires expensive scanning equipment and takesconsiderable time and practitioner attention (especially when comparedto using molding compounds).

SUMMARY OF THE DISCLOSURE

The present disclosure is directed to systems, methods, and apparatusfor orthodontic treatment. The methods include methods for creatingaccurate impressions and molds of an orthodontic patient's teeth towhich orthodontic brackets are mounted. In some embodiments, the methodsaccurately and reproducibly produce impressions of the teeth andbrackets, including archwire slots or other wire engaging structuredefined by the brackets, without damaging or debonding the brackets, ordamaging the mold, as the mold is nondeformably removed from thepatient's teeth. In some embodiments, the methods include utilizingorthodontic brackets that include a base, or support assembly, which isbonded to a patient's tooth, and a corrective assembly, which isremovably and replaceably coupled to the support assembly and whichincludes a wire engaging portion, such as an archwire-receiving slot.Such a corrective assembly is utilized to impart corrective forces tothe patient's teeth upon receipt of an archwire in the wire engagingportion. In some methods that utilize these multi-piece brackets, thecorrective assemblies are intentionally removed prior to the moldingprocess, with the support assemblies indicating the position of theassembled brackets (and optionally the corresponding archwire-receivingslots) relative to the patient's teeth. However, in some methods, thecorrective assemblies may be left coupled to the support assemblies, anddebonded after a mold is created as the mold is nondeformably removedfrom the patient's teeth.

In some embodiments, a temporarily installed marker assembly may beadapted to define or otherwise indicate the position of thearchwire-receiving slot during the molding process, but may be adaptedto be unsuitable for use during tooth-aligning use of the brackets. Insuch embodiments, a marker assembly, which may also be referred to as a“temporary corrective assembly,” a “slot indicator,” and/or a “slotmarker,” may include a marker coupling portion that is adapted toreleasably engage a support assembly and a marker portion that isadapted to indicate, when the marker assembly is engaged with thesupport assembly, the archwire-receiving slot (or other wire engagingportion or structure) of the support assembly's corresponding correctiveassembly.

In at least the above embodiment, the marker assembly may be adapted toform a portion of the mold, or model, of the patient's teeth. In otherembodiments, the marker assembly may be adapted to remain coupled to thesupport assembly after nondeformably removing the mold. Either resultmay be achieved, for example, by adapting a marker assembly, whenengaged with the support assembly, to establish a bond of a desired bondstrength relative to that established when the support assembly isengaged with its corresponding corrective assembly. In either case, suchmarker assemblies may be defined by a perimeter surface that is free ofprojections extending in a direction generally parallel to the surfaceof the portion of the tooth to which the support assembly is bonded.Such a configuration may, for example, assist removal of a set moldwithout contemporaneously removing the marker assemblies as the mold isdrawn away from the patient's teeth.

Accordingly, some methods may include, prior to the molding process,removing a corrective assembly from a support assembly, and coupling amarker assembly to the support assembly. The marker assembly may beremoved as the set mold is nondeformably removed from the patient'steeth, or separately and subsequently removed. The removed correctiveassembly, or another corrective assembly, may be recoupled to thesupport assembly, and the archwire reattached, to resume orthodontictreatment.

These and other exemplary methods may include utilizing any of theabove-described brackets and/or marker assemblies to create accuratemodels or representations of the patient's teeth. In some embodiments,the models accurately record, or reproduce, the position of the bracketsand/or archwire relative to the patient's teeth. The methods may furtherinclude thereafter utilizing the model in orthodontic treatment, such asto create computer-modeled and/or computer-created corrective assembliesand/or archwires.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic diagram showing various components of anillustrative example of a multi-piece, reusable orthodontic appliancethat may be used with systems and methods according to the presentdisclosure.

FIG. 2 is a fragmentary isometric view showing an exemplary toothengaging portion of an orthodontic appliance bonded directly to a toothsurface.

FIG. 3 is a fragmentary isometric view showing an exemplary toothengaging portion of an orthodontic appliance bonded to a band thatencircles a tooth.

FIG. 4 is a fragmentary isometric view showing an exemplary ligatingwire engaging portion of an orthodontic appliance, such as may be usedwith orthodontic appliances according to the present disclosure.

FIG. 5 is a fragmentary isometric view showing the ligating wireengaging portion of FIG. 4 engaging an archwire.

FIG. 6 is a fragmentary isometric view showing an exemplaryself-ligating wire engaging portion of an orthodontic appliance, such asmay be used with orthodontic appliances according to the presentdisclosure.

FIG. 7 is an isometric view showing the self-ligating wire engagingportion of FIG. 6 engaging an archwire.

FIG. 8 is a fragmentary, schematic perspective view of an assembledorthodontic appliance that may be used with systems and methodsaccording to the present disclosure.

FIG. 9 is an illustrative, somewhat less schematic isometric view of anassembled orthodontic appliance that may be used with systems andmethods according to the present disclosure.

FIG. 10 is a schematic diagram showing a support assembly of anorthodontic appliance secured to a tooth while a mold is being made ofthe tooth and attached portion of the orthodontic appliance.

FIG. 11 is a schematic side elevation view of a support assembly of anorthodontic appliance that may be used with systems and methodsaccording to the present disclosure, with the support assembly includinga marker portion.

FIG. 12 is an isometric view showing an illustrative example of anorthodontic appliance that includes a marker assembly that may be usedwith systems and methods according to the present disclosure.

DETAILED DESCRIPTION AND BEST MODE OF THE DISCLOSURE

The present disclosure is related to orthodontic appliances, includingmulti-piece (i.e., two or more piece) orthodontic brackets, and systemsand methods for utilizing these brackets for obtaining molds,impressions, and other representations of an orthodontic patient's teethafter installation of orthodontic brackets to the patient's teeth. Inthe context of this disclosure, the term “patient's teeth” is used toindicate all or some of the teeth of an orthodontic patient, one or moreof which have an orthodontic bracket installed thereon. For example,molds may be made from a patient's complete set of upper or lower teeth,but may also be made from a subset of a patient's upper or lower teeth,or even a single tooth. Molds may also be made from a combination of atleast one of a patient's teeth that includes an orthodontic bracket andat least one of a patient's teeth that does not include an orthodonticbracket. The systems and methods of the present disclosure include theuse of orthodontic brackets, or appliances, that each include a baseportion, or support assembly, that is adapted to be bonded to a tooth,and a corrective assembly, or bracket portion, which defines anarchwire-receiving slot or other structure to engage an archwire, andwhich is adapted to be releasably coupled to the support assembly.

In use, to apply tooth-aligning or other corrective forces to anorthodontic patient's teeth, a support assembly is adhesively (orotherwise suitably) bonded to a patient's tooth, the corrective assemblyis coupled to the support assembly, and an archwire is received andsecured into the archwire-receiving slot. Each coupled set of a supportassembly and a corrective assembly collectively may be referred to as anorthodontic bracket or an orthodontic appliance. The corrective assemblymay be coupled to the support assembly by any suitable fasteningmechanism, or coupling assembly. While not required to all embodiments,the coupling assembly may secure the corresponding support assembly andcorrective assembly together with less force than the adhesive, or othermechanism, secures the support assembly to the patient's tooth. In otherwords, the appliance may be adapted to decouple the corrective assemblyfrom the support assembly responsive to an applied force, such as anunintentional force that otherwise might debond the entire orthodonticbracket from the patient's tooth and/or an intentional force that isintended to decouple the corrective assembly without debonding thesupport assembly from the patient's tooth. Illustrative, exclusiveexamples of suitable orthodontic appliances that may (but are notrequired to be) used with the systems and methods of the presentdisclosure are disclosed in U.S. patent application Ser. No. 11/260,074,which is entitled “Reusable Multi-piece Orthodontic Appliances,” wasfiled on Oct. 26, 2005, and the complete disclosure of which is herebyincorporated by reference for all purposes.

When it is necessary or desirable to create a mold or other impression,image, or representation of the patient's teeth, mouth, or portionthereof, molding compound may be applied to the orthodontic patient'steeth, including one or more teeth to which an orthodontic appliance hasbeen installed. Optionally, the archwire may be removed from thearchwire-receiving slots of corrective assemblies prior to applying themolding compound. Additionally, and as explained in more detail below,the corrective assemblies may be uncoupled from the support assemblies,optionally with the archwire removed from the archwire-receiving slotsof the corrective assemblies prior to or after uncoupling of thecorrective assemblies from the support assemblies. With the correctiveassemblies and archwire removed from the patient's mouth, a mold orother representation of the patient's teeth may be obtained without therisk of the corrective assemblies being damaged and/or debonded from thepatient's teeth, and/or the mold being damaged or deformed by thecorrective assemblies. Similarly, molding compounds or materials, suchas polyvinylsiloxane dental impression material, among others, that areadapted to produce very accurate impressions, such as by firmlyhardening or otherwise curing, may be used even though they could notreliably (or at all) be used with conventional orthodontic brackets thatinclude a monolithic bracket structure that is adhesively bonded to atooth and which includes an archwire-receiving slot.

Although a mold created from a patient's teeth to which only supportassemblies are installed (i.e., with corrective assemblies removed)would not include an impression of the corrective assemblies of themulti-piece orthodontic appliances, the position thereof, and/or of thecorresponding archwire-receiving slot or other wire engaging portion,may be determined. For example, the dimensions of a corrective assembly,including the relative position of the archwire-receiving slot therein,are known, and thus the position of the archwire-receiving slot and/orthe corrective assembly relative to the patient's teeth can bedetermined from the mold from the impression of the support assembly. Asthe term is used herein, “position” includes any aspect of thethree-dimensional configuration or orientation of the relevantstructure. In some applications, this term may be used to refer to therelative orientation of the archwire-receiving slot relative to aportion of a patient's tooth to which the correctively assembly is, was,and/or is intended to be, bonded.

In some embodiments, the support assembly may be adapted to include amarker portion, such as an indicia, landmark, projection or recess, orother structural, physical, or detectable feature adapted to indicatethe relative position of the corresponding archwire-receiving slot. Insome embodiments, the orientation of the support assembly's perimetermay define or otherwise indicate the position of the archwire-receivingslot of the corresponding corrective assembly. In some embodiments, thesupport assembly may be shaped to have at least a perimeter surface thatis free from lateral projections or other regions that may impair orotherwise interfere with obtaining (and/or nondeformably removing)accurate molds of the support assembly. In such embodiments, a supportassembly may be provided with a marker portion prior or subsequent toinstallation to a patient's tooth. Illustrative, non-exclusive examplesinclude affixing an outwardly projecting indicator to a previouslyinstalled support assembly, shaping a perimeter surface of a supportassembly during fabrication or otherwise prior to bonding to a patient'stooth, and so forth. In some embodiments, the marker portionadditionally or alternatively is configured to be detected by a CTscanner, radiofrequency scanner, or other imaging device, such as by thecolor of the marker portion, luminescence of the marker portion,radiative property of marker portion, etc. In some embodiments, themarker portion is adapted to be inserted or otherwise installed orcoupled to the archwire-receiving slot of one or more of the correctiveassemblies of the bracket assemblies on the patient's teeth of which themold is to be formed.

In some embodiments, a temporarily installed marker assembly that isadapted for use with the orthodontic appliances (or brackets) mayinclude a marker portion, as described above, that is adapted to define,or otherwise indicate or represent the position of, thearchwire-receiving slot (or other wire engaging portion) during themolding process, but such a marker assembly may be adapted not to beused during tooth-aligning use of the brackets. For example, the markerassembly may be configured to be coupled to a support assembly and mayinclude an archwire-receiving slot that, when the marker assembly iscoupled to the support assembly, corresponds to the position of thearchwire-receiving slot of the corrective assembly that was removed fromthe support assembly and/or which is intended to be coupled to thesupport assembly. In some embodiments, the marker assembly may besimilar in shape to the corrective assembly except that it is free fromwings, projections or other structures that would be present in anactual orthodontic bracket or corrective assembly to retain (or assistin retaining) an archwire in the archwire-receiving slot. For example,the marker assemblies may be free from projections that extend, in aspaced-apart relationship, generally parallel to the surface of theportion of a tooth to which the corresponding support assembly issecured.

In some embodiments, the marker assembly is adapted to form a portion ofthe mold, or model, of the patient's teeth, while in others it isadapted to remain coupled to the support assembly subsequent to andseparate from removal of the set molding compound. In the formerexample, the marker assemblies may be coupled to the correspondingsupport assemblies by the coupling assembly that is used to secure thecorrective assemblies to the support assemblies, or may include similarcoupling structure adapted to establish, when the marker assembly isengaged with the support assembly, a bond strength substantiallyequivalent to or greater than that established between the correctiveassembly and the support assembly. In some embodiments, includingembodiments where the marker assembly is designed to form part of themold, it may be desirable to utilize a different coupling assembly ormechanism or to configure the marker assemblies to be decoupled from thesupport assemblies as the molding compound is drawn away from thepatient's teeth. In other words, a comparably lower strength bond orcoupling may be used than that used to couple the support assembly to acorrective assembly.

In some embodiments, the marker assembly may be formed from plastic oranother suitable material for use in destructive imaging/scanningprocesses, which may be utilized to generate images from the mold, andin some embodiments, the marker assemblies may be colored to be morereadily detected by imaging devices. As an illustrative example, some CTscanners are best adapted to detect white-colored surfaces.

The produced mold may be utilized for a variety of orthodonticapplications. Illustrative, non-exclusive examples of these applicationsinclude forming retainers and/or molded orthodontic devices (such asInvisalige-type devices), producing detailed models of the patient'steeth (which optionally may include attached orthodontic appliances orother brackets), creating electronic (computer-generated) models of thepatient's teeth, etc. A further illustrative, non-exclusive example ofan application for the produced mold is to determine archwire-receivingslot positions for patients of SureSmile™ therapeutics, Insignia™systems, or other applications where it is necessary to know the preciseposition of the archwire-receiving slots in an orthodontic patient'smouth. SureSmile™ therapeutics are available from Orametrix ofRichardson, Tex. SureSmile™ therapeutics require preciseelectronic/digital 3-D models of a patient's teeth, with these imagesbeing utilized for computer-driven (i.e., robotic) creation of archwiresfor orthodontic treatment. Insignia™ custom orthodontic systems areavailable from Ormco Corporation of Orange, Calif.

An illustrative, non-exclusive example of a multi-piece, reusableorthodontic appliance that may be used with the systems and methods ofthe present disclosure is schematically illustrated in FIG. 1 andgenerally indicated at 10. Appliance 10 is generally configured to bebonded to a tooth 12, such as via bonding media 14, and morespecifically to receive or otherwise engage an archwire 16 and transmitcorrective forces from the archwire to the tooth. In particular,appliance 10 includes a support assembly 20 and a corrective assembly22. As explained in greater detail herein, support assembly 20 isadapted to be bonded or otherwise secured to a tooth, and correctiveassembly 22 is adapted to receive the archwire and to direct correctiveforces exerted by the archwire to the tooth. Support assembly 20 andcorrective assembly 22 are configured to be releasably coupled, orengaged, together to collectively form orthodontic appliance 10.However, corrective assembly 22 is configured to disengage from supportassembly 20 in response to a suitable disengaging force being applied tothe appliance, such as to the corrective assembly and/or thesubsequently described engagement assembly.

In FIG. 1, the support assembly and corrective assembly areschematically illustrated as being coupled together by an engagementassembly 55. Engagement assembly 55 is adapted to releasably andrepeatedly couple the support and corrective assemblies together to forman assembled orthodontic appliance, or bracket, 10. Engagement assembly55 may, but is not required in all embodiments to, include first andsecond coupling portions, such as indicated at 34 and 54 in FIG. 1. Asillustrated, first coupling portion 34 is associated with supportassembly 20 and second coupling portion 54 is associated with correctiveassembly 22.

Engagement assembly 55 of an orthodontic appliance 10 according to thepresent disclosure, or more specifically first coupling portion 34and/or second coupling portion 54, may take any appropriate form, andmay include any manner of components including mechanical linkages,magnetic linkages, adhesive linkages, and so forth, that arecollectively configured to establish a connection or other engagement ofthe corrective assembly with the support assembly such that theengagement assembly will release responsive to a force exceeding apredetermined value applied to the corrective assembly. Some embodimentsmay, but are not required to, include combinations of such components.For example, some embodiments that include coupling portions that areadapted to fit together in a snap fit relationship may also include amagnetic linkage, such as a magnetically attractive part on one of thecoupling portions and a magnetically attracted part on the othercoupling portion.

Engagement assembly 55 may be adapted to release the corrective assemblyfrom the support assembly responsive to a suitable force applied to theorthodontic appliance, such as to the corrective assembly and/orengagement assembly. In some embodiments, the engagement assembly may beconfigured to release the corrective assembly from the support assemblywhen a suitable force is applied to a predetermined region of theengagement assembly and/or in a predetermined direction, while in otherembodiments, the particular direction and/or region may not be critical.As discussed in more detail herein, the engagement assembly oforthodontic appliances according to the present disclosure may be, butis not required to be, coupled together by a weaker bond, or weakerattachment mechanism, than the bond or mechanism that couples thesupport assembly to a tooth. Therefore, the applied force will tend todisengage the corrective assembly from the support assembly, bydisengaging the engagement assembly, rather than removing the entireappliance from a patient's tooth. Accordingly, it is within the scope ofthe present disclosure that the corrective assembly is adhesively bondedto the support assembly by a suitable bonding agent, or media. In such aconfiguration, the bonding agent preferably establishes a weaker bondbetween the corrective and structural assemblies than the bonding mediathat secures the corrective assembly to a tooth or tooth-encirclingband. In other embodiments, and as discussed, the engagement assemblyestablishes a mechanical coupling between the support and correctiveassemblies.

The components and/or structural features of support assembly 20 andcorrective assembly 22 may be configured as desired to enable repeatedengagement and disengagement of the assemblies, without destruction ordeterioration to any of the components of the appliance caused byengaging or disengaging the coupling portions. In particular, the firstand second coupling portions may be configured to be reusable afterbeing disengaged, for example by being fabricated to remain structurallyintact upon engagement and disengagement. Thus, for example, anorthodontist may install several appliances 10 to the teeth of apatient, for orthodontic treatment, without having to replace componentsthat become damaged due to disengagement during the period of thetreatment. Instead, the orthodontist, or in some embodiments even thepatient, may reengage any detached components, resuming treatment.Accordingly, the components, or assemblies, of orthodontic appliancesaccording to the present disclosure are adapted to be repeatedlydisengaged and reengaged without destruction of the components, orassemblies. For example, the corrective assemblies of an orthodonticappliance according to the present disclosure may be adapted to bedisengaged from a corresponding support assembly that is coupled to atooth in a patient's mouth. Should the corrective assembly be disengagedfrom the support assembly, such as described herein, neither the supportassembly nor the corrective assembly is damaged or otherwise renderedunable to be used as part of an orthodontic appliance 10 according tothe present disclosure. Accordingly, the assemblies may be reengaged,and thereby reused. However, it is not a requirement for an orthodonticappliance 10 to always have its support and corrective assembliesreengaged for reuse of both assemblies in all embodiments and at alltimes. For example, during orthodontic treatment, in some situations itmay be desirable to intentionally disengage the support and correctiveassemblies of an orthodontic appliance 10 according to the presentdisclosure and to reengage the support assembly, which is still coupledto a tooth, to the same or a different corrective assembly. Theabove-described systems and methods for forming detailed molds of apatient's teeth are an example of such a situation. It is further withinthe scope of the present disclosure, though not required, that thedisengaged corrective assembly may be reengaged with a different supportassembly for further use. Therefore, orthodontic appliances 10 may bedescribed as being “reusable” even though reuse is not required to allembodiments or in all applications.

Orthodontic appliances 10 according to the present disclosure have alsobeen described as being “multi-piece” orthodontic appliances. As usedherein, “multi-piece” refers to an orthodontic appliance that is acomposite structure consisting of at least two components, namely, atleast support assembly 20 and corrective assembly 22, that areconfigured to be releasably coupled together. Therefore, orthodonticappliances according to the present disclosure may include twocomponents, three components, four components, or more. The two or moreinter-engageable components define an orthodontic bracket that issecured to a tooth and which includes an archwire-receiving slot. Thesupport and corrective assemblies may be single-piece components, suchas which include a monolithic body, or base portion. However, it is alsowithin the scope of the present disclosure that the support and couplingassemblies themselves may be composite structures consisting of two ormore separable subcomponents, or that the various components andstructural features of each assembly may be integrally formed.

For example, and with continuing reference to FIG. 1, support assembly20 includes a tooth engaging portion 30 that is adapted to be bonded toa tooth 12. The support assembly further includes a support portion 32extending from the tooth engaging portion generally away from the tooth.As illustrated, the support portion includes a first coupling portion 34that is adapted to be releasably coupled to, or engaged with, correctiveassembly 22.

Tooth engaging portion 30 may include a tooth-facing rear surface 36,which may be configured as desired for being bonded or otherwise securedto tooth 12, such as with bonding media 14. As used herein, the frontsurface, or region, of an assembly or component generally refers to thesurface or region that is adapted to face away from the tooth to whichthe corresponding appliance 10 is coupled during use, while the rearsurface, or region, of an assembly or component generally refers to thesurface or region that is adapted to face the tooth to which thecorresponding appliance 10 is coupled during use of the appliance.Direct contact between the tooth-facing rear surface of the toothengaging portion is not required. Accordingly, the tooth engagingportion may additionally or alternatively be referred to as atooth-facing portion 30, and/or a portion 30 that is adapted to bebonded to a tooth. For example, rear surface 36 may be adapted to bebonded with a bonding media, such as a suitable cement and/or otheradhesive, either directly to a tooth surface 40 as shown in FIG. 2, orto a tooth band 42 that is secured around tooth 12, as shown in FIG. 3.As such, rear surface 36 may be generally planar or contoured, smooth ortextured, and/or may include ribs or other structure configured tosecure the tooth engaging portion 30 to the tooth to achieve a bond ofany desired strength.

As illustrated in FIG. 1, support portion 32 extends from tooth engagingportion 30, generally away from tooth 12. First coupling portion 34 issituated on support portion 32, and as such may be integrally formedwith support portion 32, or may be a separate structure that is coupledto the support portion, such as during fabrication, prior toinstallation of the appliance in a patient's mouth, or even duringinstallation, by any appropriate means, such as which may includemechanical, magnetic, and/or other suitable types of linkages, adhesivebonding, and so forth.

Corrective assembly 22 includes a wire engaging portion 50 that isadapted to receive archwire 16, a base portion 52 extending from thewire engaging portion and generally away from the archwire, and a secondcoupling portion 54 on the base portion. The wire engaging portion oforthodontic appliance 10 may be configured as desired to receive orotherwise accommodate an archwire, and the configuration may assistdirection of corrective forces to the tooth. Thus, although othermethods of accommodating an archwire are possible, wire engaging portion50 may include a front surface 56 with an archwire, orarchwire-receiving, slot 58, into which the archwire may be seated. Wireengaging portion 50 may further include structure adapted to securearchwire 16 in place with respect to orthodontic appliance 10, such assuitable structure to retain the archwire within archwire slot 58.

For example, wire engaging portions 50 according to the presentdisclosure may include structural features of, or similar to, a ligatingorthodontic bracket. An example of such a wire engaging portion 50 isshown in FIGS. 4 and 5 and is indicated generally at 60. In FIG. 4, anexemplary ligating wire engaging portion 60 is shown to include a frontsurface, or region, 56 featuring an archwire-receiving slot 58 and tiewings 62 that are arranged adjacent to the archwire slot, such as thesets of tie wings shown in FIG. 4 on either side of the archwire slot.As seen in FIG. 5, tie wings 62 may be used in coordination with aligature wire, elastic band, or other securing device 64 in order tosecure archwire 16 in a desired position with respect to the ligatingwire engaging portion.

It is also within the scope of the present disclosure that the wireengaging portion may include structural features of, or similar to, aself-ligating orthodontic bracket. For example, the wire engagingportion may include a releasable clamp, gate, clasp, or other suitablelocking structure that is adapted to releasably secure an archwirewithin the archwire slot. An illustrative example of a self-ligatingwire engaging portion is shown in FIGS. 6 and 7 and is generallyindicated at 70. In FIG. 6, the exemplary self-ligating wire engagingportion 70 is shown to include a front surface 56 with an archwire slot58 and a pair of support arms 72 disposed on one side of the archwireslot. Support arms 72 support a slidable locking member 74. As seen inFIG. 7, slidable locking member 74 may be moved to engage a pair ofreceiving arms 76 disposed on the opposite side of the archwire slot, tosecure archwire 16 in place with respect to the self-ligating wireengaging portion. Slidable locking member 74 essentially allows theself-ligating wire engaging portion to retain the archwire without theuse of ligatures that are adapted to secure the archwire within thearchwire slot. Member 74 may be described as being selectively slid, orotherwise moved, between a first, or open, configuration in which themember is positioned to permit the archwire to be inserted into andremoved from the archwire slot, and a second, or locked, configurationin which the member extends sufficiently across the archwire slot toprevent removal of the archwire through the slot. It is within the scopeof the present disclosure that other locking structures may be used inself-ligating wire engaging portions 70 according to the presentdisclosure. As an illustrative example, some locking structures may beadapted to pivot between locked and unlocked configurations, in whichthe locking structures are respectively positioned to retain or releasethe archwire from the archwire slot of a wire engaging portion to whichthe locking structure is secured.

Illustrative, non-exclusive examples of ligating orthodontic bracketsthat disclose structures and/or components that may be used withligating wire engaging portions 70 according the present disclosure aredisclosed in U.S. Pat. Nos. 6,302,688, 6,582,226, 4,878,840, 3,772,787,4,248,588, 4,492,573, 4,614,497, 4,698,017, 1,280,628, 1,821,171, and3,435,527, the complete disclosures of which are hereby incorporatedherein by reference for all purposes. Illustrative, non-exclusiveexamples of self-ligating orthodontic brackets that disclose structuresand/or components that may be used with self-ligating wire engagingportions 70 according to the present disclosure are disclosed in U.S.Pat. Nos. 6,659,766, 6,655,957, 6,358,045, 6,193,508, 5,857,850,5,711,666, 5,562,444, 5,322,435, 5,094,614, 4,559,012, 4,531,911,4,492,573, 4,419,078, 4,371,337, 4,077,126, 4,144,642, 4,248,588,4,698,017, 3,772,787, 4,559,012, 4,561,844, 4,655,708, 4,419,078,4,197,642, 4,712,999 and 4,171,568, the complete disclosures of whichare hereby incorporated by reference herein for all purposes. Additionalexamples of orthodontic brackets that include features that may beincorporated into orthodontic appliances according to the presentdisclosure are disclosed in U.S. Pat. No. 6,632,088, the completedisclosure of which is hereby incorporated by reference for allpurposes. The above-incorporated examples of conventional ligating andself-ligating brackets may also be utilized with embodiments oforthodontic appliances according to the present disclosure that includeat least a support assembly that is adapted to be releasably coupled(directly or indirectly) to a conventional orthodontic bracket thatincludes a monolithic body portion and/or which is otherwise adapted tobe utilized without an orthodontic appliance according to the presentdisclosure. Additional examples of conventional orthodontic bracketsthat may be incorporated into orthodontic appliances and the systems andmethods of the present disclosure are 3M, Sybron, GAC, and American orRocky Mountain orthodontic brackets.

FIGS. 8 and 9 provide graphical examples of assembled appliances 10.FIG. 8 schematically depicts an appliance with a support assembly 20 towhich a corrective assembly 22 is coupled by engagement assembly 55,with the corrective assembly being shown in fragmentary to present anysuitable archwire-receiving structure. In FIG. 8, the support assemblyis shown secured to a patient's tooth 12, such as with bonding media 14.FIG. 9 less schematically represents an appliance 10 that generallyresembles a conventional ligating orthodontic bracket, such as discussedabove with respect to FIGS. 4 and 5.

As discussed, the corrective assembly of an orthodontic applianceaccording to the present disclosure may be intentionally removed fromthe corresponding support assembly when it is necessary to produce amold of the patient's teeth (and optionally the attached supportassemblies). This is schematically illustrated in FIG. 10, in which asupport assembly 20 is shown coupled to a patient's tooth 12. Alsoindicated in FIG. 10 is a molding compound 100 that is positioned in thepatient's mouth to conform to the shape of the teeth (and attachedsupport assemblies and/or other portion of appliances 10). In FIG. 10,the molding compound is shown being supported on a carrier, or tray, 112that is inserted into the patient's mouth after being at least partiallyfilled with uncured, or unset, molding compound. After the moldingcompound is sufficiently cured, or set, such as after the passage oftime, the application of heat, the application of light, etc., the trayand molding compound are removed from the patient's mouth, nondeformablyremoving the mold from the patient's teeth and at least the supportassemblies of any orthodontic assemblies attached thereto. By“nondeformingly,” it is meant that the portion of the mold thatcorresponds to at least the portions of the patient's teeth to which thesupport assemblies are attached is not deformed, structurally altered,or otherwise damaged or permanently reshaped as the mold is removed fromthe patient's mouth.

As such, an exemplary method suitable for creating a mold of a patient'steeth to which are installed one or more orthodontic appliances eachincluding a support assembly bonded to a tooth and a correspondingcorrective assembly removably coupled to the support assembly (asdiscussed in greater detail above), includes removing a correspondingcorrective assembly from a support assembly, applying unset moldingcompound to the patient's teeth (and to at least the support assembliesbonded to the teeth), setting the molding compound into a mold, andnondeformably removing the mold from the patient's teeth (and supportassemblies).

As discussed, in some applications it may be desirable to determine fromthe produced mold the position of the archwire-receiving slot of theassembled orthodontic appliance relative to the corresponding tooth. Themold-defined position of the support assembly may indicate this positionor enable calculation of this position (as the dimensions of thecorrective assembly, and/or the archwire are known). Thus, someexemplary methods may further include, subsequent to creating andnondeformably removing a mold, determining the position of the wireengaging portion of the removed corrective assembly from the mold. Asdiscussed, it is also within the scope of the present disclosure thatthe support assembly includes an internally or externally projectingindicator, such as a tab, rib, indicia, or the like, that indicates onthe support assembly the relative position of the archwire-receivingslot. Because the produced mold will include an impression of thesupport assembly, it will also include a representation (mold portion)that corresponds to the indicator. A support assembly with such anindicator is schematically illustrated in FIG. 11, with referencenumeral 114 schematically indicating an example of an indicator thatprojects externally from, or away from, the support assembly, andreference numeral 116 schematically indicating an example of anindicator that projects internally into, or which is recessed in, thesupport assembly. Thus, some exemplary embodiments may further include,subsequent to creating and nondeformably removing a mold, determiningthe position of the wire engaging portion of the removed correctiveassembly from the impression of the support assembly in the mold.

In some exemplary methods for creating a mold of a patient's teeth towhich are installed one or more orthodontic appliances discussed indetail herein, an existing support assembly may be configured toindicate or otherwise represent the position of the archwire-receivingslot (or wire engaging portion) of the corresponding correctiveassembly, for example by affixing an externally projecting indicator(such as indicator 114) to the support assembly, or by inscribing,etching, or otherwise including an internally projecting indicator (suchas indicator 116) to the support assembly.

As also discussed, the orientation of a support assembly's perimeter mayindicate or otherwise represent the position of the archwire-receivingslot (or wire engaging portion). For example, a support assembly definedby a perimeter surface may be configured to indicate, such as via theshape of the perimeter surface, the position of the archwire-receivingslot. FIG. 11 shows a support assembly with a perimeter surface 118,which may be shaped in such a manner. Such a support assembly may beprovided with a shaped perimeter surface prior to installing the supportassembly to a patient's tooth, or the perimeter surface of an installedsupport assembly may be shaped prior to the application of unset moldingcompound in order to create a mold.

As also discussed, in some embodiments, it may be desirable to replacethe corrective assembly with a marker assembly prior to forming themold, with the marker assembly defining an archwire-receiving slot (orother wire engaging portion) that corresponds to, or otherwiserepresents, the position and orientation of the corresponding slot(and/or portion) of the corrective assembly that was removed from thesupport assembly. FIG. 12 schematically indicates at 120 anillustrative, non-exclusive example of such a marker assembly mounted ona support assembly. The marker assembly includes a marker couplingportion 122 adapted to releasably engage corresponding structure of thesupport assembly (such as via engagement assembly 55), a body 124extending from the marker coupling portion, and a marker portion 126 onthe body adapted to indicate, when the marker assembly is coupled withthe support assembly, the position of the wire engaging portion of thecorresponding corrective assembly when coupled with the supportassembly. Marker portion 126 of marker assembly 120 is shown as anarchwire-receiving slot 128, and thus may structurally replicate thewire engaging portion of a corrective assembly, but may be any structureadapted to indicate the position of the wire engaging portion of thecorrective assembly.

Also, as shown, body 124 of marker assembly 120 is defined by aperimeter surface, indicated at 130, that is free of projectionsextending in a direction generally parallel to the surface of theportion of the tooth to which the support assembly is bonded. Asdiscussed above, such a perimeter surface may prevent removal of amarker assembly from a support assembly during nondeformable removal ofthe setup, or cured, mold, and/or may also prevent damage or otherdeformation of the mold when removed. However, the marker assembly mayalternatively be designed to be removed from the support assembly as thesetup, or cured, molding compound is removed from the patient's mouth,such as by the forces applied thereto as the molding compound isnondeformably removed. For example, as discussed above, the markercoupling portion 122 may be adapted to establish a desired bond strengthwith the support assembly relative to that established between thesupport assembly and a corrective assembly, to assist or prevent themarker assembly debonding from the support assembly upon nondeformableremoval of a created mold.

As such, illustrative, non-exclusive methods of creating a mold mayadditionally include, prior to applying unset molding compound, couplinga marker assembly to the support assembly, the marker assembly includinga marker portion configured to represent the wire engaging portion ofthe corresponding corrective assembly. Moreover, in some methods,nondeformably removing the mold may include contemporaneous removal ofthe marker assembly from the support assembly, or the marker assemblymay be removed subsequent to and separately from nondeformably removingthe marker assembly from the support assembly.

Moreover, some methods of creating a mold may additionally include,subsequent to nondeformably removing the mold, reattaching or couplingthe corresponding corrective assembly to the support assembly, forexample in order to resume orthodontic treatment.

It is believed that the disclosure set forth above encompasses multipledistinct inventions with independent utility. While each of theseinventions has been disclosed in a preferred form or method, thespecific alternatives, embodiments, and/or methods thereof as disclosedand illustrated herein are not to be considered in a limiting sense, asnumerous variations are possible. The present disclosure includes allnovel and non-obvious combinations and subcombinations of the variouselements, features, functions, properties, methods and/or stepsdisclosed herein. Similarly, where any disclosure above or claim belowrecites “a” or “a first” element, step of a method, or the equivalentthereof, such disclosure or claim should be understood to include one ormore such elements or steps, neither requiring nor excluding two or moresuch elements or steps.

Inventions embodied in various combinations and subcombinations offeatures, functions, elements, properties, steps and/or methods may beclaimed through presentation of new claims in a related application.Such new claims, whether they are directed to a different invention ordirected to the same invention, whether different, broader, narrower, orequal in scope to the original claims, are also regarded as includedwithin the subject matter of the present disclosure.

1. An orthodontic treatment method for a patient's teeth to which areinstalled orthodontic appliances that each include a support assemblybonded to a tooth and a corresponding corrective assembly with anarchwire engaging portion removably coupled to the support assembly, themethod comprising: removing a plurality of corresponding correctiveassemblies from a plurality of support assemblies that are operativelycoupled to a corresponding plurality of teeth of the patient whileleaving the plurality of support assemblies operatively coupled to thecorresponding plurality of teeth of the patient; coupling a markerassembly to at least one of the plurality of support assemblies, whereinthe marker assembly includes a marker portion from which the position ofthe archwire engaging portion of the corresponding corrective assemblyof the least one of the plurality of support assemblies may bedetermined; forming, within the patient's mouth, a mold of the pluralityof support assemblies and the patient's teeth to which the plurality ofsupport assemblies are bonded, wherein the plurality of supportassemblies includes the at least one of the plurality of supportassemblies with the coupled marker assembly with the marker portionconfigured to represent the archwire engaging portion of thecorresponding corrective assembly; removing the mold from the patient'smouth without damaging or debonding the plurality of support assembliesor damaging or permanently deforming the mold; and determining, from themold, the position of the archwire engaging portion of the removedcorrective assembly of the at least one of the plurality of supportassemblies to which the marker assembly was coupled.
 2. The method ofclaim 1, wherein the method includes repeating the coupling to couple aplurality of marker portions to a corresponding number of the pluralityof support assemblies, and further wherein the determining includesdetermining, from the mold, the position of the archwire engagingportions of the removed corrective assemblies of the support assembliesto which the marker assemblies were coupled.
 3. The method of claim 1,wherein removing the mold contemporaneously removes the marker assemblyfrom the at least one of the plurality of support assemblies.
 4. Themethod of claim 1, further including creating, from the mold, anelectronic representation of the patient's teeth.
 5. The method of claim1, further including creating, from the mold, a model of the patient'steeth and the orthodontic appliances bonded thereto.
 6. The method ofclaim 5, wherein the model is a computer-generated model.
 7. The methodof claim 5, wherein the method further comprises using the model todetermine future orthodontic treatment of the patient's teeth.
 8. Themethod of claim 1, further comprising, subsequent to removing the mold,utilizing the mold to form an orthodontic device for use in orthodontictreatment of the patient's teeth.
 9. The method of claim 8, wherein theorthodontic device includes an archwire.
 10. The method of claim 8,wherein the orthodontic device includes a retainer.
 11. The method ofclaim 10, wherein the orthodontic device includes a molded orthodontictreatment device.
 12. The method of claim 1, wherein the determining theposition of the archwire engaging portion of the removed correctiveassembly includes determining the position of the archwire engagingportion of the removed corrective assembly from an impression of themarker portion in the mold.
 13. The method of claim 1, wherein thedetermining the position of the archwire engaging portion of the removedcorrective assembly includes determining the position of the archwireengaging portion of the removed corrective assembly based on theposition of the marker portion in the mold.
 14. The method of claim 13,wherein the determining the position includes determining the positionof the archwire engaging portion of the removed corrective assembly bydetecting at least one of the color, luminescence, or radiative propertyof the marker portion in the mold.
 15. The method of claim 1, whereinthe determining the position includes determining the position of thearchwire engaging portion of the removed corrective assembly using atleast one of a CT scanner and an RF scanner.
 16. The method of claim 1,wherein the determining the position includes creating a model from themold using a destructive process in which the mold is destroyed.
 17. Themethod of claim 1, further comprising, subsequent to removing the mold,removing the marker assembly from the at least one of the plurality ofsupport assemblies and recoupling the corresponding corrective assemblyto the support assembly.
 18. The method of claim 1, further comprising,subsequent to removing the mold, removing the marker assembly from theat least one of the plurality of support assemblies, selecting acorrective assembly to be coupled to the at least one of the pluralityof support assemblies responsive at least in part to the mold or a modelformed from the mold, and coupling the selected corrective assembly tothe support assembly.
 19. The method of claim 1, wherein the markerportion is configured to represent the archwire engaging portion of thecorresponding corrective assembly.
 20. The method of claim 1, whereinthe marker portion includes an archwire engaging portion that conformsto the shape and position of the archwire engaging portion of thecorresponding corrective assembly but is free from lateral projectionsextending in a direction generally parallel to the portion of thepatient's tooth to which the at least one of the plurality of supportassemblies is bonded.
 21. The method of claim 1, wherein the markerportion structurally replicates the archwire engaging portion of thecorresponding corrective assembly but is unsuitable for use as acorrective assembly during tooth-aligning use of the orthodonticappliance with an archwire.
 22. An orthodontic treatment method for apatient's teeth to which are installed orthodontic appliances that eachinclude a support assembly bonded to a tooth and a correspondingcorrective assembly with an archwire engaging portion removably coupledto the support assembly, the method comprising: removing a plurality ofcorresponding corrective assemblies from a plurality of supportassemblies that are operatively coupled to a corresponding plurality ofteeth of the patient while leaving the plurality of support assembliesoperatively coupled to the corresponding plurality of teeth of thepatient, wherein the at least one of the plurality of support assembliesfrom which the corresponding corrective assembly was removed includes amarker portion configured to represent the archwire engaging portion ofthe corresponding corrective assembly; forming, within the patient'smouth, a mold of the plurality of support assemblies and the patient'steeth to which the plurality of support assemblies are bonded, whereinthe plurality of support assemblies includes the at least one of theplurality of support assemblies that includes a marker portionconfigured to represent the archwire engaging portion of thecorresponding corrective assembly; removing the mold from the patient'smouth without damaging or debonding the plurality of support assembliesor damaging or permanently deforming the mold; and determining, from themold, the position of the archwire engaging portion of the removedcorrective assembly of the at least one of the plurality of supportassemblies to which the marker assembly was coupled.
 23. The method ofclaim 22, further including creating, from the mold, an electronicrepresentation of the patient's teeth.
 24. The method of claim 22,further including creating, from the mold, a model of the patient'steeth and the orthodontic appliances bonded thereto.
 25. The method ofclaim 24, wherein the model is a computer-generated model.
 26. Themethod of claim 24, wherein the method further comprises using the modelto determine future orthodontic treatment of the patient's teeth. 27.The method of claim 22, further including using the mold to configure anarchwire for use in orthodontic treatment of the patient's teeth. 28.The method of claim 22, further comprising, subsequent to removing themold, utilizing the mold to form an orthodontic device for use inorthodontic treatment of the patient's teeth.